Provider Demographics
NPI:1528137346
Name:PRICE, JULIE
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:PRICE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 SOMERSET BAY DR
Mailing Address - Street 2:APT. 302
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-6494
Mailing Address - Country:US
Mailing Address - Phone:410-595-6076
Mailing Address - Fax:
Practice Address - Street 1:200 HOSPITAL DR STE 506A
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-5887
Practice Address - Country:US
Practice Address - Phone:410-768-5558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD21917OtherLICENSE#